Q: When should an infant
be screened for hearing loss?
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All infants should be screened for hearing
loss no later than 1 month of age, preferably before leaving the
birth hospital. The age of a child when a hearing loss is
diagnosed is important to the development of the child’s speech,
language, social and academic development.
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Prior to universal newborn hearing
screening, the average age at which hearing loss is identified
in children was 2 to 3 years old.
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Newborn hearing screening costs about $30
per child and takes about 9 minutes to do. Costs are much higher
if a hearing loss is not diagnosed until later in life. In the
1995-1996 school year, the total U.S. costs for special
education programs for children with hearing loss exceeded $375
million. With just in time detection, diagnosis and
Intervention, children with hearing loss can perform at the same
level as their hearing peer.
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All infants, whether or not they pass their
newborn hearing screen, should have their language and hearing
skills monitored during regular visits to their baby’s doctor or
nurse.
-
All infants should have their development
including language development checked by their doctor or nurse
at 9 months, 18 months and 2 to 2 ½ years of age using a
screening test that can be used for all babies who are the same
age. This test is made up of asking the parents questions about
their baby’s development and watching the baby do things that
babies might be doing at a similar age such as babbling, saying
a word, crawling or picking up blocks. These tests are sometimes
called validated screening tests.
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Infants who are at risk for hearing loss
that gets worse over time (progressive hearing loss) or hearing
loss that develops after the baby is born (delayed-onset hearing
loss) should have at least one hearing test by 2 to 2 ½ years of
age. A baby should also have a hearing test anytime a parent is
concerned about the baby’s hearing or language milestones.
-
(The Joint Committee on Infant Hearing [JCIH]
Year 2007 Position Statement); Note: This statement is available
from the American Academy of Pediatrics (AAP)website:
www.aap.org and the JCIH
website http://www.jcih.org/
[Return to FAQs]
Q: What happens if an infant
does not pass the hearing screening?
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All infants who do not pass the hearing
screening should be referred for further testing to rule out or
confirm a hearing loss.
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All infants with confirmed hearing loss
should be referred for a comprehensive medical evaluation to
assess the causes and look for potential or related
disabilities.
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Depending on the results of the audiological
and medical examinations, infants may be referred to an early
intervention program.
-
To find out more about intervention options,
please contact CDC Info at 1-800-CDC-INFO (1-800-232-4636 or
email cdcinfo@cdc.gov
To learn more about infant hearing loss and how
the ear works you can visit
A Parent’s
Guide to Hearing Loss at our website.
My Baby’s Hearing
[Return to FAQs]
Q: How can I find resources
such as hearing screening tests that are available in my area?
To learn more about programs and services in your
area, please contact your local Early Hearing Detection Intervention
(EHDI) Program coordinator. You will find this information by going to:
http://www.infanthearing.org/states/index.html
[Return to FAQs]
Q: What does it mean to have
a false positive newborn hearing screening test?
A false positive hearing screening test result is
when a baby has normal hearing but does not pass the hearing screening.
Again this is sometimes caused by birthing debris or temporary fluid in
the ears during the hearing screening. Hearing screening tests are not
meant to diagnose hearing loss in infants. Instead, they are meant to
find all infants that might have a hearing loss. Because of birthing
debris, hearing screening tests sometimes misidentify infants as having
a hearing loss.
If a baby does not pass the newborn hearing screening test, it is VERY
important to make sure the baby gets follow-up testing to be SURE that
the baby does not have a hearing loss.
In the United States, between 10 and100 babies per 1,000 (1 to 10
percent) do not pass the screening test. Only one to three babies per
1,000 (less than 1 percent) actually have hearing loss. This means that
most of the babies referred for diagnostic testing will be shown to have
no hearing loss.
[Return to FAQs]
Q: Why don’t all
infants have a diagnostic test for hearing loss?
A diagnostic test takes a long time, it cannot be
done before a baby goes home from the birth hospital, and it is
expensive. A hearing screening test is quick, it can be done before a
baby leaves the birth hospital, and it is relatively inexpensive
.
Screening tests are common in medicine. Checking your vision with an eye
chart in the doctor’s office is a screening test. Just because you have
trouble reading the eye chart does not necessarily mean that you need
glasses. More testing is usually done by a special doctor – an eye
doctor. In the same way, if a baby does not pass the hearing screening
test, more testing is done by a specialist called an audiologist.
If a baby does not pass the newborn hearing screening test, it is VERY
important to make sure the baby gets a follow-up diagnostic test. To be
SURE that the baby does not have a hearing loss
For more information, please see
http://NewbornScreening/index.asp
http://www.asha.org/public/hearing/testing
http://www.aap.org/policy/re9846.html
http://baby_screening.asp
[Return to FAQs]
Q: What is an Auditory
Brainstem Response (ABR) test?
Auditory (hearing) Brainstem Response - a test that
checks the brain's response to sound and is measured by placing
electrodes (non-invasive and painless) on the head to record the brain’s
response to sound.
http://www.asha.org/public/hearing/testing#newborns_and_infants
[Return to FAQs]
Q: What is an Otoacoustic
Emissions (OAE)?
Otoacoustic Emissions – is a test that checks the
inner ear response to sound and is measured by placing a very sensitive
microphone in the ear canal to measure the ear’s response to sound.
http://www.asha.org/public/hearing/testing#newborns_and_infants
[Return to FAQs]
Q: What is the
difference between Auditory Brainstem Response testing and Behavioral
Audiometry Evaluation?
To To understand the difference between Auditory
Brainstem Response (ABR) testing and Behavioral Audiometry Evaluation
(please see below for an explanation), it is important to understand a
little about how the ear works.
The ear has three main parts: the outer ear, the
middle ear, and the inner ear.
-
The outer ear includes the visible portion of
the ear and the ear canal. Sound waves travel through these two
areas of the outer ear.
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The middle ear includes the eardrum (the
tympanic membrane) and three small bones (ossicles). The movement of
the tympanic membrane makes the ossicles vibrate.
-
The inner ear includes a snail-shaped
fluid-filled cochlea, which contains thousands of sound receptors
(hair cells). The inner ear is responsible for changing the sound
vibrations into electrical signals. The electrical signals are
picked up by the hearing (acoustic) nerve. The acoustic nerve sends
the sound to the brain.
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When an adult or child has a hearing loss, one
or more of these parts are not working in the usual way. In order to
fully test hearing, all parts of the ear, the acoustic nerve, and
the brain pathways that are involved in hearing must be tested for
proper functioning.
Auditory Brainstem Response (ABR) testing
focuses only on the function of the inner ear, the acoustic nerve, and
the brain pathways that are associated with hearing. This test is used
for babies, children, and adults. For this test, electrodes are placed
on the individual’s head (similar to electrodes placed around the heart
when an electrocardiogram is done), and brain wave activity in response
to sound is recorded. Because this test does not rely on behavior, the
adult or child being tested can be sound asleep during the test.
Behavioral Audiometry Evaluation tests the function of all parts
of the ear, including the acoustic nerve and the brain pathways involved
in hearing. Infants and toddlers are observed for changes in their
behavior such as sucking a pacifier, quieting, or searching for the
sound. They are rewarded for the correct response by getting to watch an
animated toy (this is called visual reinforcement audiometry). Sometimes
older children are given a more play-like activity (this is called
conditioned play audiometry). The child being tested must be awake and
cooperative during this test.
[Return to FAQs]
Q: Why is more than one
hearing screening test necessary?
Sometimes birthing debris and fluid persist in a
baby’s ear. This birthing debris and fluid can result in a failed
hearing screen. Many hospitals therefore will ask parents to return
several days later as an outpatient for a hearing re-screen after the
birthing debris has a chance to resolve from the ear.
Sorry, we can't give you medical advice. Please talk
with your doctor for questions about yourself or your family. For other
information, please contact ehdi@cdc.gov
[Return to Top]
Date: September 1, 2006
Content source: National Center on Birth Defects and Developmental
Disabilities
